Electroconvulsive therapy in therapy resistent depression in old age

In the past 30 years electroconvulsive therapy (ECT) was rarely applied in Germany mostly due to political reasons. Now ECT gains more interest again among psychiatrist as an effective somatic treatment for severe psychoses. Non-response to antidepressive medications is considered as one of the major indications for ECT. However,there are only few reports in the literature concerning the use of ECT in the treatment of late-life depression. Here we report on our experience with ECT treatment of older depressive patients (mean age 69+/-5 years) not responding to different antidepressants before ECT. There was a marked clinical improvement in 9 of the 12 (75%) cases (reduction of the Hamilton Depression Score to less than 50%). The only serious complication occurring in the sample was a transient cardiac conduction delay. Our experience show that ECT is a safe treatment also for late-life depression, which should be applied more often to avoid chronification of depression.